Evaluation On The Clinical Results Of Internal Fixation For Thoracolumbar Fractures By Posterior Pedicle Screw Without Fusion And Postoperative Intervertebral Disc Degeneration

Purpose:To evaluate the clinical efficacy of thoracolumbar fractures by posterior pedicle screw fixation without fusion and degenerative changes of interver‐tebral disc.Method:From February2010to January2012,fifty‐four patients who suffered fro‐m thoracolumbar fractures and treated by posterior pedicle screw fixation with fusion were included.And forty‐one patients,from February2012to Ja‐nuary2013, treated without fusion were included.Compare the clinical resu‐lts of the two.Unhurt intervertebral discs as reference standard,access the degenerative changes of intervertebral discs upper or lower injured verteb‐ral body.Results:Non‐fusion group can shorter the surgical time and reduce surgical bl‐ood loss and surgical draining loss.It also can effectively recover the hei‐ght of vertebral body and rectify the posterior salient.And there was no s‐ignificant difference between fusion group and non‐fusion group in the los‐s of the height recovered and the posterior salient rectified(P>0.05).In the non‐fusion group,MRI shows that there are respectively27cases and17cases of intervertebral discs upper and lower injured vertebral body recei‐ving damage at various degrees,compared with those unhurt intervertebral discs, the differences were statistical significance(P﹤0.01).One year after o‐ peration,removing the fixation,compared with the same intervertebral discs before operation,there are4cases of intervertebral discs upper or lower injured vertebral body receiving the damage at various degrees,but no si‐gnificant difference between the two（P>0.05）.And there were two new h‐igh intensity zones were discovered in the intervertebral discs upper o‐r lower injured vertebral body,both accompanied with backache at various degrees.One case of high intensity zone in the intervertebral discs upper or lower injured vertebral body disappear after removing fixation.Conclusion:Non‐fusion surgery can shorter the surgical time and reduce surgical blood loss and surgical draining loss.It can also effectively recover the height of vertebral body and rectify the posterior salient.And there was no significant difference between two groups in the loss of the height recov‐ered and the posterior salient rectified.Different thoracolumbar fractures br‐ought damage of intervertebral discs upper or lower injured vertebral bo‐dy at various degrees.One year afer operation,the intervertebral discs of n‐eighboring、upper and lower injured vertebral body did not degenerated significantly.And the high intensity zone related with backache did not ha‐ppen in a large amount.Removing the fixation,the activity degree of the Ve‐rtebral body which are fixed is recovering,avoiding degeneration of the int‐ervertebral disc neighboring injured vertebral body.